{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:04:21Z","timestamp":1768435461353,"version":"3.49.0"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,7,13]],"date-time":"2020-07-13T00:00:00Z","timestamp":1594598400000},"content-version":"vor","delay-in-days":194,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The aftermath of pelvic radiotherapy for prostate cancer (PC) can pose a significant challenge for surgeons in the management of rectal and sigmoid tumours, resulting in extensive fibrosis and difficult anatomy. Higher rates of ureteric injuries and anastomotic leakage following anterior resection (AR) have been reported with no clear consensus for an optimal approach. We present three cases, each employing a different surgical approach tailored to the individual patient-specific and disease-specific factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case<\/jats:title>\n                    <jats:p>In each case, the patient had active radiation proctitis. Case 1 was a T3 rectal cancer 9 cm from the anal verge. A non-restorative procedure was performed with a permanent end colostomy, due to the extensive pelvic fibrosis encountered in a comorbid patient. In case 2, a large rectal polyp at 12 cm from the anal verge was managed using transanal minimally invasive surgery (TAMIS) with a covering loop ileostomy. In case 3, an elderly patient with dementia with a malignant sigmoid polyp underwent a segmental resection rather than standard oncological resection, thus avoiding either a stoma or rectal anastomosis in the context of active radiation proctitis. All three patients remain well at follow-up with no evidence of recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>All three cases demonstrate an individualised approach, taking into account specific factors relating to both patient and disease. In all cases, the presence of active chronic radiation proctitis meant that primary colorectal anastomosis was not safe, thus, alternative approaches were taken.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>It is essential to tailor treatment according to patient-specific and disease-specific factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2020.07.039","type":"journal-article","created":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T12:33:39Z","timestamp":1594902819000},"page":"15-18","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Technical challenges and potential solutions for rectal and sigmoid tumours following previous radiation for prostate malignancy"],"prefix":"10.1097","volume":"74","author":[{"given":"Enda","family":"Hannan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Ryan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Desmond","family":"Toomey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-3-20260114","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1308\/003588412X13373405384611","article-title":"Interactions in the aetiology, presentation and management of synchronous and metachronous adenocarcinoma of the prostate and rectum","volume":"94","author":"Nash","year":"2012","journal-title":"Ann. R. Coll. Surg. Engl"},{"key":"R2-3-20260114","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1111\/codi.12962","article-title":"Surgery for rectal cancer after high dose radiotherapy for prostate cancer: is sphincter preservation relevant?","volume":"17","author":"Buscail","year":"2015","journal-title":"Colorectal Dis"},{"key":"R3-3-20260114","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1002\/jso.24075","article-title":"Previous radiation for prostate neoplasm alters surgical and oncologic outcomes after rectal cancer surgery","volume":"112","author":"Guandalino","year":"2015","journal-title":"J. Surg. Oncol"},{"key":"R4-3-20260114","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1111\/j.1464-410X.2011.10827.x","article-title":"Comparative analysis of prostate-specific antigen free survival outcomes for patients with low, intermediate and high risk prostate cancer treatment by radical therapy. Results from the Prostate Cancer Results Study Group","volume":"109","author":"Grimm","year":"2012","journal-title":"BJU Int"},{"key":"R5-3-20260114","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.ijsu.2018.10.028","article-title":"The SCARE 2018 statement: updating consensus surgical CAse REport (SCARE) guidelines","volume":"60","author":"A.Agha","year":"2018","journal-title":"Int. J. Surg"},{"key":"R6-3-20260114","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.ijsu.2018.10.031","article-title":"The PROCESS 2018 statement: updating consensus preferred reporting of CasE series in surgery (PROCESS) guidelines","volume":"60","author":"Agha","year":"2018","journal-title":"Int. J. Surg"},{"key":"R7-3-20260114","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.ijrobp.2009.02.025","article-title":"Dose volume constraints to reduce rectal side effects from prostate radiotherapy. Evidence from MRC RT01 Trial ISRCTN 47772397","volume":"76","author":"Guilliford","year":"2010","journal-title":"Int. J. Radiat. Oncol. Biol. Phys"},{"key":"R8-3-20260114","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.ijrobp.2009.03.078","article-title":"Radiation dose volume effects in radiation-induced rectal injury","volume":"76","author":"Michalski","year":"2012","journal-title":"Int. J. Radiat. Oncol. Biol. Phys"},{"key":"R10-3-20260114","doi-asserted-by":"crossref","first-page":"2247","DOI":"10.3748\/wjg.v24.i21.2247","article-title":"Predictive factors for anastomotic leakage after laparoscopic colorectal surgery","volume":"24","author":"Sciuto","year":"2018","journal-title":"World J. Gastroenterol"},{"key":"R11-3-20260114","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1177\/000313481508100329","article-title":"Transanal minimally invasive surgery (TAMIS): new treatment for early rectal cancer and large rectal polyps-experience of an Italian center","volume":"81","author":"Maglio","year":"2015","journal-title":"Am. Surg"},{"key":"R12-3-20260114","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1007\/DCR.0b013e3181bbd6ee","article-title":"Transanal endoscopic microsurgery resection of rectal tumours: outcomes and recommendations","volume":"53","author":"Tsai","year":"2010","journal-title":"Dis. Colon Rectum"},{"key":"R13-3-20260114","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1055\/s-0037-1606108","article-title":"Local excision and endoscopic resections for early rectal cancer","volume":"30","author":"Sao Juliao","year":"2017","journal-title":"Clin. Colon Rectal Surg"},{"key":"R14-3-20260114","doi-asserted-by":"crossref","first-page":"285","DOI":"10.15403\/jgld.2014.1121.233.mlt","article-title":"Standard versus limited colon resection for high risk T1 colon cancer. A matched case-control study","volume":"23","author":"La Torre","year":"2014","journal-title":"J. Gastrointestin. Liver Dis"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220305502?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220305502?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.07.039","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:35:22Z","timestamp":1768397722000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.07.039"}},"subtitle":["A case series"],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":13,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2020.07.039","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2020,1]]}}}